Why You May Want to Include Point-of-Care Ultrasound in Your Simulations
Ultrasound isnt just used in maternal care practices. Having come a long way since its roots in military and industrial settings, today ultrasound is well-established as a crucial technology across a range of diagnostic and therapeutic applications.
The uses vary from determining the size and sex of a fetus to boosting the accuracy of a needle biopsy to treating a soft-tissue injury.
Further, bedside point-of-care ultrasound (POCUS) has evolved into a valuable addition to an acute care clinicians toolbox in settings such as emergency and intensive care medicine.
Its fast, improves diagnostic accuracy and informs treatment plans by condensing the list of viable diagnostic etiologies.1
Herein, we discuss the applications of point-of-care ultrasound as well as why you might want to consider integrating it into your existing simulations.
POCUS: The Need to Know
Acting as one large piece of the diagnostic puzzle, POCUS findings typically indicate the next step in the care pathway.
POCUS can help reinforce core anatomy and physiology concepts, illustrate pathology and disease processes, and facilitate mastery of the physical examination. For these reasons, organizations ranging from the American Academy of Emergency Medicine to the American Institute for Ultrasound in Medicine, have advocated for POCUS as an important element of undergraduate medical education. 2 3
However, there are two caveats. First, POCUS is operator dependent. Confidence and competence in image acquisition and interpretation are essential, as is the ability to incorporate ones findings into clinical decision-making.4 Developing the necessary operator competence in ultrasound often proves problematic, as it currently consists of a see one, do one approach that requires patients, standardized patients, commercial training models or cadavers - all at substantial cost.
Second, todays ultrasound training typically lacks an emphasis on critical thinking and decision-making components - vital in emergency and intensive care settings.
POCUS mastery can be divided into three areas:
Image acquisition: Knowing when and where to scan
Image interpretation: Generating the images and knowing when the image is adequate for interpretation and data extraction
Integration into clinical care: Making decisions based on complete data (history, physical and POCUS images)11
History Repeats Itself - Even in Simulation
As point -of - care ultrasound becomes an increasingly prevalent imaging modality, medical schools and residency programs are beginning to incorporate more robust ultrasound training into the curricula. Experts cant help but draw a parallel to the history of anesthesia educators, who turned to simulation in order to train basic skills in a realistic context.
Until the 1990s, anesthesiology residents faced challenges in achieving clinical competency while maintaining patient safety. Many of the technical and non-technical skills required for anesthesia practice - from difficult airway management and lung separation to effective teamwork - are ideally acquired by exercises and experiences rather than traditional lectures.
The emergence of high-fidelity mannequin simulators and simulation-based training effectively addressed these challenges. Anesthesiology residents trained with simulators were found to respond more quickly, perform better and deviate less from accepted procedures.5 Other researchers reported better cardiopulmonary resuscitation performance6, reduction in costs and complications related to central catheter insertion7, higher scores in cardiopulmonary bypass weaning and superior non-technical skills in simulation training groups.
Why is medical simulation training so effective? Experience has shown that simulation
Serves as an alternative to a live patient Is experiential learning-based. Offers varying levels of fidelity. Increases engagement and maximizes retention. Allows for debriefing. Improves teamwork.
Adding Vitality to Your Ultrasound Training
Simulation training is particularly well-suited for mastering point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. It is rapid, accurate, repeatable, cost-effective, noninvasive and without the risk of radiation, and may be used in both stable and unstable patients. It may also be performed parallel to physical examination, resuscitation and stabilization, which can add significant value to medical schools and residency programs ultrasound training.9
The link between simulation and safety
For diagnostic and therapeutic tools like ultrasound, simulation is a key component in the quest for improved patient safety because it:12
Helps enhance diagnostic capabilities: Seventeen percent of patient harm stems from improper diagnosis alone.*
Encourages critical thinking and teamwork: Patient care is increasingly provided by interdisciplinary teams that must work together seamlessly.
A survey by the Association of American Medical Colleges found that more than 80% of medical schools had incorporated simulation-based instruction within all four years of their curriculum.10 Among nursing schools, 87% have incorporated simulation-based training with high or medium-fidelity mannequins within the curriculum.11
Many schools have access to simulation equipment - its use simply has yet to reach full capacity when it comes to ultrasound. That means the majority of todays chief residents and clinical directors did not experience the value of simulation firsthand in their own ultrasound training, and may not recognize the opportunity it presents to optimize the teaching of this clinical skill.
With point - of - care ultrasound fast becoming an extension of the clinical examination, simulation-based education is the vehicle of choice to meet emerging educational needs, as well as ultimately improving patient safety and outcomes.
With team training solutions such as the Laerdal SonoSim Ultrasound Solution now available, programs that currently use Laerdal simulators may find they can be expanded to include POCUS training capabilities
High-quality patient simulation for training a multitude of medical procedures and patient cases.
SimMom� is an advanced full body birthing simulator with accurate anatomy and functionality to facilitate multi-professional obstetric training of birth management, with both manual and automatic delivery modes.
1 American Academy of Emergency Medicine. AAEM clinical practice committee statement: Ultrasound should be integrated into undergraduate medical education curriculum. J Emerg Med. 2015; 49(1):89-90. doi: 10.1016/j.jemermed.2014.12.092
2 Goldstein SR. "President's letter: "Contagious enthusiasm" for ultrasound in medical education." American Institute of Ultrasound Medicine. http://www.aium.org/soundwaves/article.aspx?aId=785&iId=20140626. Published June 26, 2014. Accessed September 1, 2017.
3 Parks, et al. Can medical learners achieve point-of-care ultrasound competency using a high-fidelity ultrasound simulator?: a pilot study. Critical Ultrasound Journal 2013 5:9
4 Chopra V, Gesink BJ, de Jong J, Bovill JG, Spierdijk J, Brand R. Does training on an anaesthesia simulator lead to improvement in performance? Br J Anaesth 1994; 73: 293-7.
5 Wayne DB, Didwania A, Feinglass J, Fudala MJ, Barsuk JH, McGaghie WC. Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study. Chest 2008; 133: 56-61
6 Barsuk JH, McGaghie WC, Cohen ER, O'Leary KJ, Wayne DB. Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Crit Care Med 2009; 37: 2697-701.
7 Bruppacher HR, Alam SK, LeBlanc VR, Latter D, Naik VN, Savoldelli GL, et al. Simulation-based training improves physicians' performance in patient care in high-stakes clinical setting of cardiac surgery. Anesthesiology 2010; 112: 985-92.
8 Abu-Zidan FM, Zayat I, Sheikh M, Mousa I, Behbehani A. Role of ultrasonography in blunt abdominal trauma: A prospective study. Eur J Surg. 1996;162:361�5.[PubMed: 8781916]
9 Passiment M, Sacks H, Huang G. Medical Simulation in Medical Education: Results of an AAMC Survey. Washington, DC; 2011. https://www.aamc.org/download/259760/data/medicalsimulationinmedicaleducationanaamcsurvey.pdf. Accessed September 1, 2017.
10 Hayden J. Use of simulation in nursing education: national survey results. J Nurs Regul. 2010;1(3):52�57.
11. Lewiss, Resa & Hoffmann, Beatrice & Beaulieu, Yanick & Phelan, Mary Beth. (2014). Point-of-Care Ultrasound Education The Increasing Role of Simulation and Multimedia Resources. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. Doi 33. 27-32. 10.7863/ultra.33.1.27.
12. Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US); 2000. 2, Errors in Health Care: A Leading Cause of Death and Injury. Available from: https://www.ncbi.nlm.nih.gov/books/NBK225187
The Stethoscope of the Future?
Why You May Want to Include Point-of-Care Ultrasound in Your Simulations
Ultrasound isnt just used in maternal care practices. Having come a long way since its roots in military and industrial settings, today ultrasound is well-established as a crucial technology across a range of diagnostic and therapeutic applications.
The uses vary from determining the size and sex of a fetus to boosting the accuracy of a needle biopsy to treating a soft-tissue injury.
Further, bedside point-of-care ultrasound (POCUS) has evolved into a valuable addition to an acute care clinicians toolbox in settings such as emergency and intensive care medicine.
Its fast, improves diagnostic accuracy and informs treatment plans by condensing the list of viable diagnostic etiologies.1
Herein, we discuss the applications of point-of-care ultrasound as well as why you might want to consider integrating it into your existing simulations.
POCUS: The Need to Know
Acting as one large piece of the diagnostic puzzle, POCUS findings typically indicate the next step in the care pathway.
POCUS can help reinforce core anatomy and physiology concepts, illustrate pathology and disease processes, and facilitate mastery of the physical examination. For these reasons, organizations ranging from the American Academy of Emergency Medicine to the American Institute for Ultrasound in Medicine, have advocated for POCUS as an important element of undergraduate medical education. 2 3
However, there are two caveats. First, POCUS is operator dependent. Confidence and competence in image acquisition and interpretation are essential, as is the ability to incorporate ones findings into clinical decision-making.4 Developing the necessary operator competence in ultrasound often proves problematic, as it currently consists of a see one, do one approach that requires patients, standardized patients, commercial training models or cadavers - all at substantial cost.
Second, todays ultrasound training typically lacks an emphasis on critical thinking and decision-making components - vital in emergency and intensive care settings.
POCUS mastery can be divided into three areas:
Image acquisition: Knowing when and where to scan
Image interpretation: Generating the images and knowing when the image is adequate for interpretation and data extraction
Integration into clinical care: Making decisions based on complete data (history, physical and POCUS images)11
History Repeats Itself - Even in Simulation
As point -of - care ultrasound becomes an increasingly prevalent imaging modality, medical schools and residency programs are beginning to incorporate more robust ultrasound training into the curricula. Experts cant help but draw a parallel to the history of anesthesia educators, who turned to simulation in order to train basic skills in a realistic context.
Until the 1990s, anesthesiology residents faced challenges in achieving clinical competency while maintaining patient safety. Many of the technical and non-technical skills required for anesthesia practice - from difficult airway management and lung separation to effective teamwork - are ideally acquired by exercises and experiences rather than traditional lectures.
The emergence of high-fidelity mannequin simulators and simulation-based training effectively addressed these challenges. Anesthesiology residents trained with simulators were found to respond more quickly, perform better and deviate less from accepted procedures.5 Other researchers reported better cardiopulmonary resuscitation performance6, reduction in costs and complications related to central catheter insertion7, higher scores in cardiopulmonary bypass weaning and superior non-technical skills in simulation training groups.
Why is medical simulation training so effective? Experience has shown that simulation
Serves as an alternative to a live patient Is experiential learning-based. Offers varying levels of fidelity. Increases engagement and maximizes retention. Allows for debriefing. Improves teamwork.
Adding Vitality to Your Ultrasound Training
Simulation training is particularly well-suited for mastering point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. It is rapid, accurate, repeatable, cost-effective, noninvasive and without the risk of radiation, and may be used in both stable and unstable patients. It may also be performed parallel to physical examination, resuscitation and stabilization, which can add significant value to medical schools and residency programs ultrasound training.9
The link between simulation and safety
For diagnostic and therapeutic tools like ultrasound, simulation is a key component in the quest for improved patient safety because it:12
Helps enhance diagnostic capabilities: Seventeen percent of patient harm stems from improper diagnosis alone.*
Encourages critical thinking and teamwork: Patient care is increasingly provided by interdisciplinary teams that must work together seamlessly.
A survey by the Association of American Medical Colleges found that more than 80% of medical schools had incorporated simulation-based instruction within all four years of their curriculum.10 Among nursing schools, 87% have incorporated simulation-based training with high or medium-fidelity mannequins within the curriculum.11
Many schools have access to simulation equipment - its use simply has yet to reach full capacity when it comes to ultrasound. That means the majority of todays chief residents and clinical directors did not experience the value of simulation firsthand in their own ultrasound training, and may not recognize the opportunity it presents to optimize the teaching of this clinical skill.
With point - of - care ultrasound fast becoming an extension of the clinical examination, simulation-based education is the vehicle of choice to meet emerging educational needs, as well as ultimately improving patient safety and outcomes.
With team training solutions such as the Laerdal SonoSim Ultrasound Solution now available, programs that currently use Laerdal simulators may find they can be expanded to include POCUS training capabilities
High-quality patient simulation for training a multitude of medical procedures and patient cases.
SimMom� is an advanced full body birthing simulator with accurate anatomy and functionality to facilitate multi-professional obstetric training of birth management, with both manual and automatic delivery modes.
1 American Academy of Emergency Medicine. AAEM clinical practice committee statement: Ultrasound should be integrated into undergraduate medical education curriculum. J Emerg Med. 2015; 49(1):89-90. doi: 10.1016/j.jemermed.2014.12.092
2 Goldstein SR. "President's letter: "Contagious enthusiasm" for ultrasound in medical education." American Institute of Ultrasound Medicine. http://www.aium.org/soundwaves/article.aspx?aId=785&iId=20140626. Published June 26, 2014. Accessed September 1, 2017.
3 Parks, et al. Can medical learners achieve point-of-care ultrasound competency using a high-fidelity ultrasound simulator?: a pilot study. Critical Ultrasound Journal 2013 5:9
4 Chopra V, Gesink BJ, de Jong J, Bovill JG, Spierdijk J, Brand R. Does training on an anaesthesia simulator lead to improvement in performance? Br J Anaesth 1994; 73: 293-7.
5 Wayne DB, Didwania A, Feinglass J, Fudala MJ, Barsuk JH, McGaghie WC. Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study. Chest 2008; 133: 56-61
6 Barsuk JH, McGaghie WC, Cohen ER, O'Leary KJ, Wayne DB. Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Crit Care Med 2009; 37: 2697-701.
7 Bruppacher HR, Alam SK, LeBlanc VR, Latter D, Naik VN, Savoldelli GL, et al. Simulation-based training improves physicians' performance in patient care in high-stakes clinical setting of cardiac surgery. Anesthesiology 2010; 112: 985-92.
8 Abu-Zidan FM, Zayat I, Sheikh M, Mousa I, Behbehani A. Role of ultrasonography in blunt abdominal trauma: A prospective study. Eur J Surg. 1996;162:361�5.[PubMed: 8781916]
9 Passiment M, Sacks H, Huang G. Medical Simulation in Medical Education: Results of an AAMC Survey. Washington, DC; 2011. https://www.aamc.org/download/259760/data/medicalsimulationinmedicaleducationanaamcsurvey.pdf. Accessed September 1, 2017.
10 Hayden J. Use of simulation in nursing education: national survey results. J Nurs Regul. 2010;1(3):52�57.
11. Lewiss, Resa & Hoffmann, Beatrice & Beaulieu, Yanick & Phelan, Mary Beth. (2014). Point-of-Care Ultrasound Education The Increasing Role of Simulation and Multimedia Resources. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. Doi 33. 27-32. 10.7863/ultra.33.1.27.
12. Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US); 2000. 2, Errors in Health Care: A Leading Cause of Death and Injury. Available from: https://www.ncbi.nlm.nih.gov/books/NBK225187
The Colles Fracture Reduction Trainer is an ideal training tool for learners looking to gain confidence in the reduction of Colles’fractures occurring at the distal end of the radius.
Minimize downtime and maximize education with Worry-Free Simulation, an exclusive, limited time upgrade promotion from Laerdal Medical for existing customers to enjoy considerable savings while also avoiding any training disruption.
3B Scientific, a leading manufacturer and marketer of medical simulation products and anatomical models for healthcare education, announces today that it has reached an agreement to acquire Lifecast Body Simulation.
On behalf of the National Sea Rescue Institute's Training, Lifeguarding and Drowning Prevention Departments, we would like to extend our deepest gratitude to you and your company for your incredibly generous donation of the inflatable CPR manikins.
Suitable for all levels of training, the Hand & Wrist Injection Trainer allows trainees and clinicians to practice and teach injections in five different locations within the hand and wrist.
The 3B Scientific Birthing Simulator P90 PRO has been developed for the skill training in normal deliveries, in complicated deliveries and in obstetric emergencies.
SimBaby™ with Tracheostomy is a 9-month-old pediatric simulator with a controllable tracheostoma. It allows you to train for specific learning objectives on initial assessment and treatment, in addition to realistically simulating tracheostomy care.
The first Patient Communication Simulator that sees, listens, and responds using artificial intelligence (AI). ALEX is an untethered, on-the-go patient simulator
For most women, pregnancy is a time of anticipation and change. Emotions of joy and anxiety collide as hormone levels increase to accommodate new life. But, for some women, the fear of miscarriage is ever-present.
As the global source of the official resuscitation science and education guidelines used by training organizations and healthcare professionals, the 2020 American Heart Association Guidelines for CPR and ECC deliver the latest resuscitation science education available to ensure the highest quality of care of improved outcomes.
The Pool Rescue Manikin is a revolutionary new product designed to innovate the way lifeguard training is conducted. This product brings together different elements of lifeguard training, allowing trainees to seamlessly practice different techniques without needing to switch between different equipment or live volunteers. We think that this lifeguard training manikin is the ideal tool for all leisure centres, swimming pools and clubs.
A variant model of our popular Man Overboard manikin, the Helicopter Winch Manikin was designed in consultation with the experts at Bristow Helicopters UK to provide a solution for training horizontal lifts from the water.
Each year, more than 700 women die in the United States from pregnancy related complications; the highest number compared with other high-income countries.
iSimulate just released a free Point of Care Training Kit to the app store. It simulates multiple point-of-care devices in one and works on mobile phones. The app simulates the following devices for Point of Care training:
Trainer for hemorrhage control on upper extremity with realistic wound and bleeding simulation. Improve pre-hospital patient care training with instructional and hands-on training of hemorrhage control with wound packing and tourniquet application
SimMom and MamaBirthie combined provides an impactful simulation toolkit, which can be used at different stages of the Circle of Learning to support a complete learning experience.
Implement skills development training in donning and doffing PPE in a way that allows clinicians to practice until confident and competent. This e-learning course and scenarios for peer-to-peer skills enables healthcare providers to train effectively with minimal facilitators required.
The Coronavirus disease (COVID-19) has created a healthcare crisis that has put a major training burden on hospitals, emergency medical services, and long-term care facilities, among others.
SimCapture allows you to effectively manage, record, and assess simulation training, both on-site and in-situ. Capture audio, video, annotations, patient monitors, and simulator data in a single web-based interface.
The Norwegian Prime Minister announced today together with Laerdal Medical’s Chairman and CEO Tore Laerdal, a new emergency ventilator that will double the amount of ventilators in Norway.
The Advanced Catheterization Trainer Set contains both the Male and Female Catheterization Trainers, a pelvic shell & stand for each separate module, and two water systems.
The new Little Baby QCPR and Resusci Baby QCPR manikins are designed to deliver quality infant CPR training through real-time and summative performance feedback.
The Emergency Evacuation Manikin was designed in response to the growing demand for a manikin suitable for emergency evacuation training within care homes and other health care settings.
Over the past few years, escape rooms have become an increasingly popular educational and training tool. Used originally as a fun social activity, escape rooms are now being used as a means to drive learning.
SimBaby with Tracheostomy is a 9-month-old pediatric simulator with a controllable tracheostoma. It allows you to train for specific learning objectives on initial assessment and treatment, in addition to realistically simulating tracheostomy care.
The training and education benefits of using simulation in a clinical environment have been proven across healthcare. Learners who participate in simulation training see improvements in retention, skills acquisition, and confidence compared to those who experience only didactic training.
The Little Anne QCPR manikin helps instructors improve the quality and efficiency of bystander CPR training while adding a fun and engaging element for learners.
Now available with a QCPR Race game to help make learning “stick,�? plus a QCPR Classroom app for training large groups, Little Anne QCPR brings CPR training to the next level.
Achieving student engagement is a fundamental challenge in any form of education, especially when the student is a beginner or is someone refreshing their skills. If you are an instructor in Cardiopulmonary Resuscitation (CPR), you've likely struggled to keep people engaged - especially when teaching laypeople.
With realistic chest stiffness, hand placement sensor, and the new SkillReporter app, Resusci Baby QCPR offers a new level of precision training for treating babies in cardiac arrest.
Little Baby QCPR is a realistic and affordable BLS manikin for pediatrics. By utilizing gamified learning and objective feedback, Little Baby QCPR improves training quality, learner engagement, and classroom efficiency.